{
  "abstract": "Background Germany has the highest density of cigarette vending machines globally, and the recent proliferation of electronic cigarette (e-cigarette) vending machines raises growing public health concerns, particularly regarding youth exposure. However, limited data exist on their spatial distribution and contextual placement. This study presents the first spatial analysis of e-cigarette vending machines in Germany, using the Berlin-based company ‘ Vape4Me’ as a case study.Methods Geo-referenced data on e-cigarette vending machine locations were extracted from the Vape4Me website and cross-validated using Google Maps and Microsoft Bing Maps. Spatial analyses—including density mapping, proximity assessments and co-location analysis—were conducted using ArcGIS Pro, R and OpenRouteService. Associations with population size were examined through regression analysis. Selected sites in Cologne and Wiesbaden were visited for on-site validation.Results A total of 316 ( Vape4Me) e-cigarette vending machines were identified in Germany, with the highest concentration in Berlin. Machine density was significantly associated with population size, with a 3.24% increase per 1000 additional residents. In Berlin, vending machines were frequently co-located with hospitality and commercial establishments and rarely placed near outdoor or public utility areas. On-site inspections revealed that machines offered disposable e-cigarettes for around €10, with basic age verification.Conclusion The integration of e-cigarette vending machines into everyday environments—combined with continuous advertising and 24/7 access—normalises e-cigarette use and poses challenges to tobacco control efforts. Stronger regulations, including bans on the sale of cigarettes and e-cigarettes via vending machines, are urgently needed to protect youth from early nicotine exposure.",
  "authors": [
    {
      "affiliations": [
        "Division of Policy and Implementation Research for Cancer Prevention, DKFZ Hector Cancer Institute at the University Medical Center Mannheim, Germany, German Cancer Research Center (DKFZ), Heidelberg, Germany",
        "Department of Health Sciences, Global Health Unit, Groningen University, Groningen, Netherlands"
      ],
      "name": "Sisay Mulugeta Alemu"
    },
    {
      "affiliations": [
        "Division of Primary Cancer Prevention, German Cancer Research Center (DKFZ), Heidelberg, Germany",
        "Medical Faculty, Heidelberg University, Mannheim, Germany"
      ],
      "name": "Ute Mons"
    },
    {
      "affiliations": [
        "Cancer Prevention Unit and WHO Collaborating Center for Tobacco Control, German Cancer Research Center (DKFZ), Heidelberg, Germany"
      ],
      "name": "Katrin Schaller"
    },
    {
      "affiliations": [
        "Division of Policy and Implementation Research for Cancer Prevention, DKFZ Hector Cancer Institute at the University Medical Center Mannheim, Germany, German Cancer Research Center (DKFZ), Heidelberg, Germany"
      ],
      "name": "Ezgi Baltaci"
    },
    {
      "affiliations": [
        "Division of Policy and Implementation Research for Cancer Prevention, DKFZ Hector Cancer Institute at the University Medical Center Mannheim, Germany, German Cancer Research Center (DKFZ), Heidelberg, Germany",
        "International Health Department, Health Systems Program, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA"
      ],
      "name": "Connie Hoe"
    }
  ],
  "title": "Spatial distribution of e-cigarette vending machines: a case study from Germany",
  "uid": "6de19d30-3b7b-5175-9a57-d0c6c18b0c10"
}